Gastroesophageal Reflux Disease

• Etiology/Risk Factors
  • Hiatal hernia
  • Obesity
  • Diet
  • Pregnancy
• Pathophysiology
  • Reflux of gastric contents in esophagus (Figure 6.32)
    • Causes mucosal injury
    • Often occurs during sleep
  • Chronic aspiration can lead to significant pulmonary pathology
    • Bronchial asthma
    • Chronic cough
    • Pharyngitis
    • Chronic bronchitis
    • Idiopathic pulmonary fibrosis
• Treatment
  • Dietary modifications
  • H₂ antagonists
  • PPIs
  • Surgery
• Primary Concerns
  • ↑ Risk of aspiration
  • Difficult airway
    • Eroded enamel
    • Inflamed pharyngeal/laryngeal structures [102]
  • ↑ Risk of pulmonary pathology
• Evaluation
  • History
    • Duration of symptoms
    • Triggers
    • When do symptoms occur
    • Current symptoms
• Anesthesia Management
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